Impaired decisional impulsivity in pathological videogamers

Abstract

Background: Pathological gaming is an emerging and poorly understood problem. Impulsivity is commonly impaired in disorders of behavioural and substance addiction, hence we sought to systematically investigate the different subtypes of decisional and motor impulsivity in a well-defined pathological gaming cohort.

Methods: Fifty-two pathological gaming subjects and age-, gender- and IQ-matched healthy volunteers were tested on decisional impulsivity (Information Sampling Task testing reflection impulsivity and delay discounting questionnaire testing impulsive choice), and motor impulsivity (Stop Signal Task testing motor response inhibition, and the premature responding task). We used stringent diagnostic criteria highlighting functional impairment.

Results: In the Information Sampling Task, pathological gaming participants sampled less evidence prior to making a decision and scored fewer points compared with healthy volunteers. Gaming severity was also negatively correlated with evidence gathered and positively correlated with sampling error and points acquired. In the delay discounting task, pathological gamers made more impulsive choices, preferring smaller immediate over larger delayed rewards. Pathological gamers made more premature responses related to comorbid nicotine use. Greater number of hours played also correlated with a Motivational Index. Greater frequency of role playing games was associated with impaired motor response inhibition and strategy games with faster Go reaction time.

Conclusions: We show that pathological gaming is associated with impaired decisional impulsivity with negative consequences in task performance. Decisional impulsivity may be a potential target in therapeutic management.

Figure 1. Information sampling task outcome measures.

Mixed measures ANOVA of Information Sampling Task outcomes as a function of cost. Left: Boxes opened; Right: Points. Abbreviations: HV  =  healthy volunteers; VG  =  pathological gamers; YBOCS-G  =  modified Yale-Brown Obsessive Compulsive Score for gaming.

Figure 2. Delay discounting and information sampling task.

K-value of the delay discounting task.

Figure 3. Correlation of severity measures with task outcomes.

A. Correlation analyses of video gaming severity based on modified Yale Brown Obsessive Compulsive Scale scores adapted for gambling with Information Sampling Task outcome measures. B. Correlation analysis of video game hours played per week with Motivation Index from the premature responding task.

Figure 4. Linear regression of game types with task outcomes.

A. Linear regression analysis of the frequency of strategy games played (p = 0.02) with Go Reaction Time (GoRT) from the Stop Signal Task and boxes opened from the Information Sampling Task remaining in the model. B. Linear regression analysis of the frequency of role playing games played (p = 0.01) with Stop Signal Reaction Time (SSRT) remaining in the model.